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J Alzheimers Dis. 2018;61(2):589-600. doi: 10.3233/JAD-160973.

Neuroanatomical Comparison of the "Word" and "Picture" Versions of the Free and Cued Selective Reminding Test in Alzheimer's Disease.

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Gerosciences Center for Brain Health and Metabolism, Providencia, Santiago, Chile.
Laboratory of Neuropsychology and Clinical Neuroscience (LANNEC), Physiopathology Program - ICBM and Neurological Sciences Department and Neurology Department, Faculty of Medicine, Universidad de Chile Santiago, Santiago, Chile.
Memory and Neuropsychiatric Clinic (CMYN), Neurology Service - Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile.
Center for Advanced Research in Education (CIAE), Universidad de Chile, Santiago, Chile.
Department of Neurology, Clínica Alemana -Universidad del Desarollo, Santiago, Chile.
Norwich Medical School, University of East Anglia, Norwich, UK.
DCLL, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Department of Neuroradiologic, Institute of Neurosurgery Asenjo, Santiago, Chile.
Department of Neurology and Neurosurgery, Clinical Hospital, Universidad de Chile, Santiago, Chile.


Episodic memory tests with cued recall, such as the Free and Cued Selective Reminding Test (FCSRT), allow for the delineation of hippocampal and prefrontal atrophy contributions to memory performance in Alzheimer's disease (AD). Both Word and Picture versions of the test exist but show different profiles, with the Picture version usually scoring higher across different cohorts. One possible explanation for this divergent performance between the different modality versions of the test might be that they rely on different sets of neural correlates. The current study explores this by contrasting the neural correlates of the Word and Picture versions of the FCSRT with voxel-based morphometry (VBM) in AD and healthy subjects. We predicted that the Picture version would be associated with different cortical regions than the Word version, which might be more hippocampal-centric. When comparing 35 AD patients and 34 controls, AD patients exhibited impairments on both versions of the FCSRT and both groups performed higher in the Picture version. A region of interest analysis based on prior work revealed significant correlations between free recall of either version with atrophy of the temporal pole and hippocampal regions. Thus, contrary to expectations, performance on both the Word and the Picture version of the FCSRT is associated with largely overlapping networks. Free recall is associated with hippocampal volume and might be properly considered as an indicator of hippocampal structural integrity.


Alzheimer’s disease; FCSRT Picture version; FCSRT Word version; Free and Cued Selective Reminding Test; biomarkers; episodic memory; hippocampus; voxel based morphometry


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